Chest
-
Comparative Study
Salbutamol delivery from a hydrofluoroalkane pressurized metered-dose inhaler in pediatric ventilator circuits: an in vitro study.
The aim of our study was to determine the in vitro delivery of salbutamol from a pressurized metered-dose inhaler (pMDI) containing hydrofluoroalkane (HFA) propellant through various delivery devices to four models of a pediatric lung. ⋯ Salbutamol from an HFA pMDI is delivered efficiently through inline holding chambers with reduced static in pediatric ventilator settings. A large holding chamber has no advantage over a small holding chamber. In addition, salbutamol delivery is more efficient through a holding chamber than through a nonchamber device.
-
Comparative Study
Prevalence of patent foramen ovale and its contribution to hypoxemia in patients with obstructive sleep apnea.
The objectives of this study were (1) to assess the prevalence of patent foramen ovale (PFO) by means of contrast transesophageal echocardiography (TEE) in patients with obstructive sleep apnea, and (2) to determine the potential contribution of right to left interatrial shunting to systemic oxygen desaturation following the performance of Valsalva maneuver. ⋯ We conclude that there is an increased prevalence of PFO in patients with obstructive sleep apnea that could contribute to significant hypoxemia after a Valsalva maneuver in approximately one third of these patients.
-
To assess the incidence of acute mechanical causes precipitating sudden cardiac arrest in cardiac surgery patients during the immediate postoperative period. In addition, we report the success rate of cardiopulmonary resuscitation (CPR) in which open-chest CPR was employed at an early stage of the resuscitation effort. ⋯ Mechanical factors account for a substantial portion (28%) of causes of sudden cardiac arrest occurring in hemodynamically stable patients during the immediate postoperative period. This high incidence, in conjunction with the high survival rate achieved by open CPR, supports an early approach to open-chest CPR in this group of patients.
-
To assess the utilization of venous thromboembolism (VTE) prophylaxis in a medical-surgical ICU. ⋯ Eighty-six percent of the medical-surgical patients included in this study received VTE prophylaxis. The utilization of VTE prophylaxis described in this study is higher compared to previously published data. The nature of physician coverage in our medical-surgical ICU (closed unit), consistent practice patterns of a designated ICU staff, and a continuing medical education program involving VTE prophylaxis are the factors believed to be responsible for these results.
-
Case Reports
Bilateral partial bronchial obstruction due to broncholithiasis treated with laser therapy.
The previously recognized modes of therapy for symptomatic broncholithiasis are broncholithectomy via surgery or bronchoscopy. A 46-year-old woman with bilateral partial bronchial obstruction was treated with Nd-YAG laser with complete resolution of symptoms and of airway obstruction.